WONに対する内視鏡的ドレナージ後に発症した十二指腸狭窄に対して保存的加療が奏功した1例

抄録

A 67-year-old woman with infected walled-off necrosis (WON) after post endoscopic retrograde cholangiopancreatography pancreatitis was transferred to our hospital. Computed tomography (CT) guided percutaneous drainage and endoscopic trans-duodenal drainage to the infected WON were performed. The WON improved after drainage, and all drainage tubes were removed on discharge. However, 1 month later, she was admitted to our hospital due to vomiting. Abdominal CT scan showed a remarkable duodenal stenosis. Esophagogastroduodenoscopy and upper gastrointestinal series showed that duodenal fistula remained and beaky stenosis developed in the 2nd to 3rd portion of the duodenum. A nasal duodenal drainage tube was placed immediately above the stenosis. The stenosis was improved dramatically after 2 weeks. Thus, the drainage tube was effective in treating duodenal stenosis with remaining fistula, and surgery was avoided.